Epidermal growth factor and basic fibroblast growth factor increase the production of matrix metalloproteinases during in vitro decidualization of rat endometrial stromal cells

Numerous growth factors are involved in mediating proliferation and differentiation of endometrial stromal cells during decidualization. During this period, the extracellular matrix of the endometrium undergoes extensive remodeling. We tested the hypothesis that epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), and transforming growth factor-beta regulate expression of matrix metalloproteinases (MMPs) and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs), during decidualization. Stromal cells were isolated from uteri hormonally sensitized to undergo decidualization and were cultured in the absence or presence of a growth factor. Using substrate-gel electrophoresis with gelatin as the substrate, we detected activity for gelatinase A and B, and collagenase-3, and using casein as a substrate, we detected activity for stromelysin-1. Increasing concentrations of EGF and bFGF resulted in increased activity of gelatinase B, collagenase-3, and stromelysin-1. Northern blot analyses revealed that EGF and bFGF also increased messenger RNA levels for these MMPs. There was no effect of these growth factors on gelatinase or TIMP-1, -2, and -3, nor was there an effect of transforming growth factor-beta on any MMP or TIMP examined. These data demonstrate that EGF and bFGF increase levels of proteolytic enzymes produced by endometrial stromal cells undergoing decidualization in vitro while having no effect on their inhibitors.     

Genomic structure, chromosomal localization, and conserved alternative splice forms of thrombopoietin

Thrombopoietin (TPO), the ligand for c-mpl, is a novel cytokine comprising an amino terminal domain with homology to erythropoietin and a glycosylated carboxyl terminal domain that does not bear overall homology to other known proteins. We report the cloning of cDNAs encoding the porcine and murine TPO and the characterization of the human TPO gene. The cDNA for an additional splice form (TPO-2) with a four-amino-acid deletion within the erythropoietin-like domain has been isolated and is conserved between humans, pigs, and mice. Species comparison of TPO shows that the amino terminal erythropoietin-like domain is highly conserved, while the carboxyl terminal domain is less conserved. Recombinant murine TPO and human TPO are each able to activate both the murine and human c-mpl receptors, indicating an absence of strict species specificity. Human TPO is encoded by a single gene consisting of six exons and located on chromosome 3q27-28.     

国产盐酸特拉唑嗪治疗高血压病100例疗效观察

选择Ⅰ或Ⅱ期高血压病患者１００例用国产盐酸特拉唑嗪片治疗与另５０例高血压病患者使用美国Ａｂｂｏｔｔ公司产盐酸特拉唑嗪片（高特灵）治疗，并进行疗效对比观察。结果发现，国产盐酸特拉唑嗪片总有效率为９０％，高特灵总有效率为８３％，两组间疗效无明显差异（Ｐ＞０．０５）。均无明显副作用，对脂代谢呈有益作用，可视为治疗高血压病较好的药物。     

Alimentary tract tuberculosis. A continuing challenge to gastroenterologists—Report of 55 cases

Although uncommon in developed countries gastrointestinal tuberculosis is an important treatable disease and the diagnosis is often difficult. Between November 1982 and November 1985 tuberculosis was diagnosed in 544 patients at the Armed Forces Hospital, Riyadh. Of these 55 (10.11%) had tuberculosis of the gastrointestinal tract confirmed by histology and/or microbiology, from material obtained during surgical exploration or endos-copy. Disease was located in the oesophagus and stomach (4), small bowel (18), large bowel (15), peritoneum (21) and liver (11). The proportion of alimentary tract tuberculosis found in this study is high when compared with other reports. The presentation, diagnosis and response to treatment of these 55 patients is described and the value of endoscopy in diagnosis is illustrated.     

Effect of warfarin on prothrombin synthesis and secretion in human Hep G2 cells

Prothrombin synthesis and secretion were studied in a human hepatoma cell line (Hep G2) incubated with 35S-methionine for 2 to 24 hours at 37 degrees C. Extracellular and intracellular prothrombin were detected by immunoprecipitation with affinity-purified antiprothrombin antibody. Incorporation of 35S-methionine into prothrombin was monitored by counting specific bands excised from 10% sodium dodecyl sulfate- polyacrylamide gel electrophoresis (SDS-PAGE). Prothrombin represented 0.3% to 0.7% of total newly synthesized protein secreted into the media. Warfarin had no effect on total prothrombin synthesis (extracellular plus intracellular). However, warfarin inhibited secretion of newly synthesized prothrombin by 58% to 73% over a 2 to 4 hour period. This was accompanied by the intracellular accumulation of an immunoprecipitable species of prothrombin of 78 kd, 6 kd less than extracellular prothrombin. At the end of the 4-hour incubation with warfarin, intracellular prothrombin increased from 44% to 82% (twofold) of total prothrombin, whereas extracellular prothrombin decreased from 56% to 19% (threefold) of total prothrombin. After 24-hour incubation with warfarin, intracellular and extracellular immunoprecipitable prothrombin approached control values. Deglycosylation of extracellular and intracellular prothrombin with hydrofluoric acid (HF) resulted in a decrease in mol wt for both species to 66 kd. Endoglycosidase-H treatment, which digests "early mannosyl" residues, resulted in a decrease in the mol wt of the intracellular species of 8 kd with no effect on the extracellular species. Thus, the lower mol wt intracellular species that accumulates following early warfarin treatment is due to the presence of incompletely processed carbohydrate chain. The data are compatible with the hypothesis that optimum glycosylation and secretion require Vitamin K-dependent carboxylation.     

Radical retropubic prostatectomy and blood transfusion

OBJECTIVE: To determine whether there is a reduction in blood loss and blood transfusions associated with radical retropubic prostatectomy (RRP) by measuring the amount of blood loss and incidence of red blood cell (RBC) transfusions over time along with factors that may influence transfusions. PATIENTS AND METHODS: This is a retrospective study of patients who underwent RRP with and without the nerve-sparing dorsal venous complex (DVC) technique from 1985 to 1993 and in 1999. Transfusion rate, mean RBC loss, and preoperative and postoperative hemoglobin values were assessed. Univariate and multivariate regression analyses were performed. RESULTS: A total of 438 RRPs (276 DVC technique, 162 non-DVC technique) were reviewed and included in the study. The percentage of patients receiving allogeneic RBC transfusion decreased from 69% during 1985 to 1986 to 7.1% during 1999, and there was a decline in discharge hemoglobin values from 12.0 to 10.9 g/dL during this period. There was a significant reduction in mean hemoglobin concentration lost over time in the DVC technique group from 4.9 to 4.0 g/dL (P=.04) during the 1985 to 1990 study period, which persisted in 1999. CONCLUSION: Improvement in surgical technique and reduction in transfusion triggers resulted in large decreases of allogeneic RBC transfusions in patients undergoing RRP.     

雷帕霉素-替罗非班复合药物涂层支架的血液及组织相容性

目的:观察雷帕霉素-替罗非班复合药物涂层支架置入后再狭窄、血栓、生化指标和重要器官组织病理学变化情况,评估其血液及组织相容性。方法:实验于2005-03/11在解放军第四军医大学实验外科实验室完成。以聚合高分子材料为药物载体,采用微喷法制备雷帕霉素支架及雷帕霉素-替罗非班复合药物涂层支架。实验分组:8只小型猪按随机数字表法分为两组,复合药物组和雷帕霉素组,每组4只。复合药物组应用雷帕霉素-替罗非班复合药物涂层支架,雷帕霉素组应用雷帕霉素支架。再狭窄模型采用国际公认的小型猪冠状动脉过度扩张再狭窄模型。每只猪于冠状动脉中成功置入上述支架各2枚。术后两组小型猪服用硫酸氯吡格雷75mg/d抗血小板治疗,雷帕霉素组服用3个月,复合药物组服用1个月。实验评估:①观察术后动物行为状态。②支架置入术前、术后2,7d,4,12周分析全血细胞计数、生化指标。③麻醉后处死动物,取出支架置入段血管,行组织病理学观察,计算管腔面积丢失率。管腔面积丢失率(%)=(支架围绕面积-管腔面积)/支架围绕面积×100%。④取肺、肝、肾组织及支架血管段供血的心室壁行组织学观察。结果:8只小型猪均进入结果分析。①术后动物行为学观察:两组术前、术中及术后3个月造影时,动物心率、血压、体质量的变化差异无显著性意义,术后也无明显行为异常及饮食、排尿便异常。②血细胞计数和生化检测结果:复合药物组、雷帕霉素组术后2d白细胞计数均高于术前[分别为(13.1±2.8)×109,(7.2±2.1)×109L-1;(12.5±3.3)×109,(6.3±2.2)×109L-1],差异有显著性意义(t=3.37,3.08,P<0.05);其余各时段两组外周全血红细胞、白细胞、血小板计数差异无显著性意义(P>0.05)。γ-血清谷丙转氨酶、谷氨酰转肽酶及肌酐、尿素氮未见明显改变(P>0.05)。③血管组织病理学检测:两组血管均未见附壁血栓。复合药物组血管腔面积、新生内膜面积高于雷帕霉素组[分别为(4.96±0.35),(4.89±0.46)mm2;(1.12±0.10),(1.05±0.09)mm2],管腔面积丢失率低于雷帕霉素组[(19±9)%,(21±7)%],差异均无显著性意义(P>0.05)。④重要脏器大体形态及病理学检查:证实细胞形态结构正常,无炎性细胞浸泡、出血和坏死。结论:雷帕霉素-替罗非班复合药物涂层支架置入小型猪冠状动脉后3个月的血液相容性及组织相容性良好,并可减少术后抗血小板药物的全身用药量。     

一氧化氮代谢物的测定及其与病毒性肝炎若干相关因素的分析

测定了423例各型肝炎、肝炎后肝硬化患者一氧化氮代谢物NO2-／NO3-的值，并与42例正常人作对照，结果肝硬化组NO2-/NO3-值高于对照组及其他各型肝炎组（P＜0．01）。肝硬化NO2-／NO3-的升高与血浆白蛋白（ALB）呈负相关，与腹水量呈正相关，与门脉宽度呈正相关．而与TBA、SB、ALT、AST、凝血酶原活动度等无相关性。提示一氧化氮可能在高动力循环、腹水生成、白蛋白合成方面起重要作用。     

External Defibrillation Failure Due to Antimicrobial Incise Drape

Antimicrobial incise drapes adhere to a patient's skin during surgery in an attempt to reduce surgical infections. We describe a patient undergoing repeated aortic valve replacement who experienced sudden ventricular fibrillation before median sternotomy. External defibrillation was unsuccessful on multiple attempts using several defibrillators. On removal of the incise drape from the patient's chest, external defibrillation was immediately successful. Increased transthoracic impedance can be caused by multiple factors and may prevent defibrillation. To our knowledge, this is the first reported case of an antimicrobial incise drape preventing defibrillation. If external defibrillation, cardioversion, or pacing is indicated intraoperatively, we recommend prompt removal of the antimicrobial incise drapes before electrode placement if the drapes overlay the intended pad position. Since this case, our institutional practice has now changed to placement of 2 external adhesive defibrillator electrodes onto the patient's skin lateral to the surgical field before incise drape application to allow for defibrillation.     

Sarcoidosis in children. Epidemiology in Danes, clinical features, diagnosis, treatment and prognosis

This paper reviews current knowledge of childhood sarcoidosis with regard to the epidemiology in Danes, clinical presentation, diagnostic procedures, treatment and prognosis. Sarcoidosis is a granulomatous disease of unknown aetiology, with multiorgan involvement. The diagnosis is confirmed by the demonstration of epitheloid cell granulomas in tissue biopsy specimens. During the period 1980-92, three cases of childhood sarcoidosis were recorded in Copenhagen County, which has a total population of 610,000. The approximate incidence of clinically recognized sarcoidosis in Danish children younger than 15 y of age was 0.22-0.27/100,000 children per year, corresponding to approximately three new cases in Denmark each year. The true incidence is unknown, since the disease is often asymptomatic and resolves without a clinical diagnosis being made. In children younger than 5y of age, the disease is characterized by involvement of skin, eyes and joints, whereas in older children involvement of lungs, lymph nodes and eyes predominate. The mainstay of treatment consists of oral corticosteroids. The risk/benefit ratio of using long-term corticosteroids needs to be evaluated in each individual patient. Some patients may benefit from additional therapy with methotrexate. The long-term prognosis is not well established, but it seems to be poorer in children younger than 5 y. Older children appear to have as favourable a prognosis as young adults.